Adding up risks: Sexual debut and substance use among Italian university students

BACKGROUND: The literature has analysed the effect of problem behaviours on the timing of first sexual intercourse, showing a positive association between them, but scant information is available about the effect on the other circumstances of sexual debut, such as the use of protection and having a casual partner, with few studies on Southern European countries. OBJECTIVE: This study addresses whether and how the initiation and the timing of some risky behaviours (problem drinking and marijuana, ecstasy and other drug use) are associated with the timing of sexual debut, the use of protection and the type of first sexual partner. METHODS: Event history analyses for the transition to first sexual intercourse – also in their competing risk form – are performed on data referring to Italian university students aged 18-26, collected in 2000-2001 and 2017. RESULTS: The risk of having first sexual intercourse steadily increases as the number of first-time risky behaviours increases. The negative effect of the accumulation of risky behaviours seems to be accentuated at very early ages; for those having their first intercourse with a casual partner; for young women having their first intercourse without any form of protection; and for young men having their first intercourse irrespective of the use of protection. CONTRIBUTION: Our results show that even in a country such as Italy, where family and sexual norms are relatively traditional, young people confident with alcohol, marijuana and ecstasy use are more likely to experience risky sexual intercourse. This provides evidence for the political agenda on educating safe sex.